5 ( reviews)
HIGH ACUITY EXAM 1
PRACTICE QUESTIONS WITH
RATIONALE 2026 LATEST
QUESTIONS AND ANSWERS
VERIFIED A+.
Terms in this set (198 terms)
To determine whether there is a delay in impulse
conduction through the ventricles, the nurse will measure
the duration of the patient's
a. P wave. c. PR interval.
b. Q wave. d. QRS complex. -
Correct Answer -ANS: D
The QRS complex represents ventricular depolarization.
The P wave represents the depolarization of the atria. The
PR interval represents depolarization of the atria,
atrioventricular node, a bundle of His, bundle branches,
and the Purkinje fibers. The Q wave is the first negative
deflection following the P wave and should be narrow and
short.
Cognitive Level: Understand (comprehension)Chapter
The nurse needs to quickly estimate the heart rate for a
patient with a regular heart rhythm. Which method will be
best to use?
a. Count the number of large squares in the R-R interval
and divide by 300.
b. Print a 1-minute electrocardiogram (ECG) strip and
count the number of QRS complexes.
1
, 5 ( reviews)
c. Use the 3-second markers to count the number of QRS
complexes in 6 seconds and multiply by 10.
d. Calculate the number of small squares between one
QRS complex and the next and divide into 1500. -
Correct Answer -ANS: C
This is the quickest way to determine the ventricular rate
for a patient with a regular rhythm. All the other methods
are accurate but take longer.
Cognitive Level: Analyze (analysis)
A patient has a junctional escape rhythm on the monitor.
The nurse will expect the patient to have a heart rate of
_____ beats/min.
a. 15 to 20 c. 40 to 60
b. 20 to 40 d. 60 to 100 -
Correct Answer -ANS: C
If the sinoatrial (SA) node fails to discharge, the
atrioventricular (AV) node will automatically discharge at
the normal rate of 40 to 60 beats/minute. The slower rates
are typical of the bundle of His and Purkinje system and
may be seen with failure of both the SA and AV node to
discharge. The normal SA node rate is 60 to 100
beats/min.
The nurse obtains a rhythm strip on a patient who has had
a myocardial infarction and makes the following analysis:
no visible P waves, PR interval not measurable,
ventricular rate of 162, R-R interval regular, and QRS
complex wide and distorted, and QRS duration of 0.18
second. The nurse interprets the patient's cardiac rhythm
as
a. atrial flutter. c. ventricular fibrillation.
b. sinus tachycardia. d. ventricular tachycardia. -
Correct Answer -ANS: D
2
, 5 ( reviews)
The absence of P waves, wide QRS, rate greater than 150
beats/min, and the regularity of the rhythm indicate
ventricular tachycardia. Atrial flutter is usually regular, has
a narrow QRS configuration, and has flutter waves
present representing atrial activity. Sinus tachycardia has
P waves. Ventricular fibrillation is irregular and does not
have a consistent QRS duration.
DIF: Cognitive Level: Apply (application)
The nurse notes that a patient's heart monitor shows that
every other beat is earlier than expected, has no visible P
wave, and has a QRS complex that is wide and bizarre in
shape. How will the nurse document the rhythm?
a. Ventricular couplets
b. Ventricular bigeminy
c. Ventricular R-on-T phenomenon
d. Multifocal premature ventricular contractions -
Correct Answer -ANS: B
Ventricular bigeminy describes a rhythm in which every
other QRS complex is wide and bizarre looking. Pairs of
wide QRS complexes are described as ventricular
couplets. There is no indication that the premature
ventricular contractions are multifocal or that the R-on-T
phenomenon is occurring.
DIF: Cognitive Level: Apply (application)
A patient has a sinus rhythm and a heart rate of 72
beats/min. The nurse determines that the PR interval is
0.24 seconds. The most appropriate intervention by the
nurse would be to
a. notify the a provider immediately.
b. document the finding and monitor the patient.
c. give atropine per agency dysrhythmia protocol.
3
, 5 ( reviews)
d. prepare the patient for temporary pacemaker insertion. -
Correct Answer -ANS: B
First-degree atrioventricular block is asymptomatic and
requires ongoing monitoring because it may progress to
more serious forms of heart block. The rate is normal, so
there is no indication that atropine is needed. Immediate
notification of the health care provider about an
asymptomatic rhythm is not necessary.
DIF: Cognitive Level: Apply (application)
A patient who was admitted with a myocardial infarction
experiences a 45-second episode of ventricular
tachycardia, then converts to sinus rhythm with a heart
rate of 98 beats/min. Which action should the nurse take
next?
a. Immediately notify the health care provider.
b. Document the rhythm and continue to monitor the
patient.
c. Prepare to give IV amiodarone per agency dysrhythmia
protocol.
d. Perform synchronized cardioversion per agency
dysrhythmia protocol. -
Correct Answer -ANS: C
The burst of sustained ventricular tachycardia indicates
that the patient has significant ventricular irritability, and
antidysrhythmic medication administration is needed to
prevent further episodes. The nurse should notify the
health care provider after the medication is started.
Cardioversion is not indicated given that the patient has
returned to a sinus rhythm. Documentation and continued
monitoring are not adequate responses to this situation.
DIF: Cognitive Level: Analyze (analysis)
4
HIGH ACUITY EXAM 1
PRACTICE QUESTIONS WITH
RATIONALE 2026 LATEST
QUESTIONS AND ANSWERS
VERIFIED A+.
Terms in this set (198 terms)
To determine whether there is a delay in impulse
conduction through the ventricles, the nurse will measure
the duration of the patient's
a. P wave. c. PR interval.
b. Q wave. d. QRS complex. -
Correct Answer -ANS: D
The QRS complex represents ventricular depolarization.
The P wave represents the depolarization of the atria. The
PR interval represents depolarization of the atria,
atrioventricular node, a bundle of His, bundle branches,
and the Purkinje fibers. The Q wave is the first negative
deflection following the P wave and should be narrow and
short.
Cognitive Level: Understand (comprehension)Chapter
The nurse needs to quickly estimate the heart rate for a
patient with a regular heart rhythm. Which method will be
best to use?
a. Count the number of large squares in the R-R interval
and divide by 300.
b. Print a 1-minute electrocardiogram (ECG) strip and
count the number of QRS complexes.
1
, 5 ( reviews)
c. Use the 3-second markers to count the number of QRS
complexes in 6 seconds and multiply by 10.
d. Calculate the number of small squares between one
QRS complex and the next and divide into 1500. -
Correct Answer -ANS: C
This is the quickest way to determine the ventricular rate
for a patient with a regular rhythm. All the other methods
are accurate but take longer.
Cognitive Level: Analyze (analysis)
A patient has a junctional escape rhythm on the monitor.
The nurse will expect the patient to have a heart rate of
_____ beats/min.
a. 15 to 20 c. 40 to 60
b. 20 to 40 d. 60 to 100 -
Correct Answer -ANS: C
If the sinoatrial (SA) node fails to discharge, the
atrioventricular (AV) node will automatically discharge at
the normal rate of 40 to 60 beats/minute. The slower rates
are typical of the bundle of His and Purkinje system and
may be seen with failure of both the SA and AV node to
discharge. The normal SA node rate is 60 to 100
beats/min.
The nurse obtains a rhythm strip on a patient who has had
a myocardial infarction and makes the following analysis:
no visible P waves, PR interval not measurable,
ventricular rate of 162, R-R interval regular, and QRS
complex wide and distorted, and QRS duration of 0.18
second. The nurse interprets the patient's cardiac rhythm
as
a. atrial flutter. c. ventricular fibrillation.
b. sinus tachycardia. d. ventricular tachycardia. -
Correct Answer -ANS: D
2
, 5 ( reviews)
The absence of P waves, wide QRS, rate greater than 150
beats/min, and the regularity of the rhythm indicate
ventricular tachycardia. Atrial flutter is usually regular, has
a narrow QRS configuration, and has flutter waves
present representing atrial activity. Sinus tachycardia has
P waves. Ventricular fibrillation is irregular and does not
have a consistent QRS duration.
DIF: Cognitive Level: Apply (application)
The nurse notes that a patient's heart monitor shows that
every other beat is earlier than expected, has no visible P
wave, and has a QRS complex that is wide and bizarre in
shape. How will the nurse document the rhythm?
a. Ventricular couplets
b. Ventricular bigeminy
c. Ventricular R-on-T phenomenon
d. Multifocal premature ventricular contractions -
Correct Answer -ANS: B
Ventricular bigeminy describes a rhythm in which every
other QRS complex is wide and bizarre looking. Pairs of
wide QRS complexes are described as ventricular
couplets. There is no indication that the premature
ventricular contractions are multifocal or that the R-on-T
phenomenon is occurring.
DIF: Cognitive Level: Apply (application)
A patient has a sinus rhythm and a heart rate of 72
beats/min. The nurse determines that the PR interval is
0.24 seconds. The most appropriate intervention by the
nurse would be to
a. notify the a provider immediately.
b. document the finding and monitor the patient.
c. give atropine per agency dysrhythmia protocol.
3
, 5 ( reviews)
d. prepare the patient for temporary pacemaker insertion. -
Correct Answer -ANS: B
First-degree atrioventricular block is asymptomatic and
requires ongoing monitoring because it may progress to
more serious forms of heart block. The rate is normal, so
there is no indication that atropine is needed. Immediate
notification of the health care provider about an
asymptomatic rhythm is not necessary.
DIF: Cognitive Level: Apply (application)
A patient who was admitted with a myocardial infarction
experiences a 45-second episode of ventricular
tachycardia, then converts to sinus rhythm with a heart
rate of 98 beats/min. Which action should the nurse take
next?
a. Immediately notify the health care provider.
b. Document the rhythm and continue to monitor the
patient.
c. Prepare to give IV amiodarone per agency dysrhythmia
protocol.
d. Perform synchronized cardioversion per agency
dysrhythmia protocol. -
Correct Answer -ANS: C
The burst of sustained ventricular tachycardia indicates
that the patient has significant ventricular irritability, and
antidysrhythmic medication administration is needed to
prevent further episodes. The nurse should notify the
health care provider after the medication is started.
Cardioversion is not indicated given that the patient has
returned to a sinus rhythm. Documentation and continued
monitoring are not adequate responses to this situation.
DIF: Cognitive Level: Analyze (analysis)
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